Assessment- [B] - Cardiovascular

Front 1

hollow, muscle, 4 chambers, inverted cone

Back 1

heart

Front 2

anterior chest area overlying heart and great vessels is called

Back 2

precordium

Front 3

where is the heart located

Back 3

Extends vertically from Left 2nd to Left 5th ICS

Extends horizontally from Right Sternal Border to Left MidClavicular Line

Front 4

To count ribs - start at where?

Back 4

sternal notch

Front 5

from sternal notch, move down to lump with ribs on either side, that landmark =

Back 5

2nd Rib / ICS

Front 6

What great vessel returns blood to right atrium

Back 6

vena cava

Front 7

what great vessel carries deoxygenated blood to lungs, exits Right Ventricle

Back 7

pulmonary artery

Front 8

what great vessel carries Oxygenated blood from the lungs to the left atrium

Back 8

pulmonary veins

Front 9

what great vessel transports blood from LV to body - this is the STRONGEST, BIGGEST vessel going to the ENTIRE body

Back 9

Aorta

Front 10

What is the area called where the trachae split

Back 10

angle of louis / sternal notch

Front 11

what produces the HEART sounds?

Back 11

closing of the valves

Front 12

name the two ATRIOVENTRICULAR valves?

Back 12

tricuspid (RIGHT)
MITRAL (LEFT) aka bicuspid valve

Front 13

name the two SEMILUNAR valves

Back 13

pulmonic (RIGHT)
aortic (LEFT)

Front 14

what valve is the LOUDEST?

Back 14

MITRAL VALVE

Front 15

where is the BASE located on the heart?

Back 15

AT THE TOP

Front 16

where is the APEX located on the heart?

Back 16

AT THE BOTTOM

Front 17

Find the Sternal Notch/AOL
Find the 2nd ICS count down
to the 5th ICS to find the

Back 17

heart

Front 18

less pressure, blood just went through ENTIRE body, it is not oxygenated where?

Back 18

vena cava

Front 19

what empties into vena cava

Back 19

jugulars

Front 20

distention could be caused by

Back 20

fluid overload

Front 21

R side of heart pump blood to the lungs through the

Back 21

Pulmonary ARTERY

Front 22

the biggest, strongest artery =

Back 22

Aaorta

Front 23

WHAT SIDE OF heart is bigger, stronger, pumps blood to the entire body

Back 23

Left Side of HEART

Front 24

What takes blood to BRAIN, large arteries , easy to get them

Back 24

Caratoid Arteries

Front 25

to seee a pulsation in neck from caratoid veins, the pt must be

Back 25

lying down

Front 26

Pressure on L Side of Heart is measured by

Back 26

BLOOD PRESSURE

Front 27

What our located internally and externally

Back 27

jugular veins

Front 28

jugular pulses are important in determining

Back 28

hemodynamics of Right heart

Front 29

filling of the heart -
AV valves open (mitral/tricuspid)
Ventricles FILL

Back 29

Diastole (heart at rest)

Front 30

Emptying of the heart
AV valves CLOSE
causing the S1 sound ....
Ventricles CONTRACT
semilunar valves close
causing the S2 sound.

Back 30

Systole

Front 31

WHAT SOUND

Closing of the AV valves

Back 31

S1

Front 32

WHAT SOUND

Closure of the semilunar valves

Back 32

S2

Front 33

WHAT SOUND

Alot of fluid hitting the Ventricular wall during DIASTOLE (normal under 30)

Back 33

s3 ventricular gallop

Front 34

What makes you hear sound of blood through the heart?

Back 34

an abnormal amt of fluid
through a NORMAL valve, vessels.

Front 35

3 reasons why you may hear a murmor?

Back 35

1 - Abnormal amt of fluid through a normal valve, normal vessels (CHF)

2- Normal amt of fluid through a bad vessel (calcium/narrowing of vessels)

3- SHUNTING (artificial hole b/w 2 organs)

Front 36

what kind of murmors are NEVER OKAY

Back 36

DIASTOLIC MURMORS =BAD

Front 37

Fluid hitting walls of ventricles during diastole causes what sound

Back 37

S3

Front 38

A DIASTOLIC sound heard right before S1 , due to the DISTENEDED VENTRICLE, Blood hits a HARD STIFF WALL (htn)

Back 38

s4 = hard stiff wall

Front 39

S4 sounds under 30 are considered

Back 39

normal

Front 40

artificial hole bw 2 organs , collaterol circulation buildiup leading to murmors is called

Back 40

shunting

Front 41

s4 sounds heard over 30 years old are signs of

Back 41

HTN

Front 42

what is heard over pulmonic, varies with RESPIRATION

Back 42

split s1, split s2

Front 43

what is the most common split

Back 43

split s2

Front 44

over 30, split s1 + s2 are

Back 44

dangerous

Front 45

measures the electrical current generated by the heart

Back 45

EKG

Front 46

measures long period changes of the heart

Back 46

halter monitor

Front 47

a treatedmill, monitored test

Back 47

stress test

Front 48

WHAT IS THE ELECTROLTYE OF THE HEART

Back 48

POTTASIUM

Front 49

what shows soft area of heart and blood flow, noninvasive, ultrasound waves used to assess cardiac structure, mobility valves

Back 49

Echocardiography

Front 50

An echocardiography can be done as what

Back 50

stress test

thallium imaging at rest or during excercise test

Front 51

What provides information about dysrhythmias, myocardial ischemia, cardiac hypertrophy, electrolyye imbalances, effectiveness of cardiac drugs

Back 51

EKG

Front 52

What diagnoses cardiomyapathy, valvular disorders, pericardial effusions, LV function, aneurysm , tumors ....

Back 52

Echocardiography

Front 53

You want what lipids to be high - such as salmon, olive oil ,omegas

Back 53

HDL

Front 54

triglycerids must be done how?

Back 54

fasting blood test

Front 55

arterial narrowing - looking for artery problem, INVASIVE, need Fluroscopy and Contrast material.
(can be done selectively)

Back 55

Angiography

Front 56

An angiography is done when what is suspected?

Back 56

arterial obstruction, narrowing, aneurysm

Front 57

what is the MOST DEFINITIVE, BEST INVASIVE TEST to study the heart and coronary arteries

Back 57

CARDIAC CATHERIZATION

Front 58

POST CARDIAC CATH, if you notice CHEST PAIN, INSERTION SITE PAIN, DIZZINESS, DEC URINE, DYSRHYTHMIAS, BLEEDING, HEMATOMA, NEUROLOGIC CHAGNES,..........YOU MUST

Back 58

Notify MD

Front 59

POST CARDIAC CATH,
BEDREST
keep head of bed elevated and......

Back 59

insertion site EXTREMELY STRAIGHT for 4-6 hours

monitor vitals , inspect site, neuros

Front 60

Fluid overload, pressure on RIGHT side of heart , best seen lying flat or 90 degreee angle

Back 60

neck vein distention

Front 61

WHAT IS THE FIRST SIGN OF INTERNAL BLEEDING!

Back 61

INCREASED HEART RATE!

Front 62

POST CARDIAC CATH, watch pt for ____________

Back 62

BLEEDING AT INSERTION SITE, FEMORAL ARTERY ....NOTIFY DOCTOR

Front 63

if you find an irregular peripheral pulse, you must

Back 63

take APICAL pulse

Front 64

where you hear MITRAL valves closing the best, should never be more than 2cm, palpalble is called

Back 64

Point of Max Impulse

Front 65

what must you palpate seperately

Back 65

caratoid arteries

Front 66

The Mitral area LEFT MIDCLAVICLAR LINE AT 5TH ICS is the

Back 66

point of maximum implulse

Front 67

pump 20 mg above , listen/palpae , feel for when pulse disappears...this is known as the

Back 67

ausculatory gap

Front 68

A + 4 PULSE =

A +2 PULSE =

Back 68

+4 = BOUNDING
+2 = NORMAL
+1 = WEAK

Front 69

At the APEX and TRICUSPID area - what sound is greater?

Back 69

A/T = S1 SOUNDS GREATER

Front 70

What can be heard best at ERBS POINT?

Back 70

Murmors

Front 71

What can be heard best at Pulmonic and Aortic

Back 71

P/A = S2 SOUNDS LOUDER

Front 72

What is heard last, an abnormal sound

Back 72

carotoid bruits

Front 73

where are murmors heard best and with what side of steth?

Back 73

murmors are heard best at ERBS POINT with BELL, then diaphragm

Front 74

Ausculate over the entire __________

Back 74

PRECORDIUM

Front 75

rate and rhythm at apex

Back 75

S1 heard loudest

Front 76

What occurs with CARATOID PULSE

Back 76

S1 occurs with Caratoid Pulse

Front 77

when left side valves close slgihtly before right side valves (this is heard best on the right side) what occurs?

Back 77

SPLIT S1 OR SPLIT S2

Front 78

Normal psychological splitting is wider on

Back 78

INSPIRATION

Front 79

when splitting is wider on EXPIRATION, it is called

Back 79

PARADOXICAL SPLITTING

Front 80

An ex of a PARADOXICAL SPLITTING is a

Back 80

M. I.

Front 81

Start AUSCULATATION where?

Back 81

APEX (s1 loudest)

Front 82

LISTEN FOR S2 sounds with what part of steth

Back 82

diaphragm

Front 83

SPLIT S2 heard loudest where?

Back 83

Aortic and Pulmonic site

Front 84

Split S1 heard loudest where?

Back 84

TRICUSPID (RIGHT side of heart)

Front 85

RIGHT SIDE OF HEART IS SOFTER - SPLIT SOUNDS ARE HEARD LOUDEST WHERE?

Back 85

right side of heart

Front 86

a split s2 (the sound of what valves closing?)

Back 86

RIGHT PULMONIC

Front 87

what is heard best at APEX

Back 87

DIASTOLIC

Front 88

What landmark is at the 5 ICS, left sternal border, listen with bell - HEARD BEST IN LEFT VENTRICLE

Back 88

APEX

Front 89

an S3 sound is indicative of

Back 89

Congestive heart failure

Front 90

an s4 sound is indiciative of

Back 90

HTN

Front 91

DIASTOLIC sounds heard best with bell at apex and 5 ICS, LSB - what is happening here?

Back 91

blood hitting wall

Front 92

murmors are heard best with bell or diaphragm

Back 92

BELL

Front 93

what causes DECREASED OR ABSENT pulses, cool temperatire, loss of hair, severe pain w excercise , thick rigid nails

Back 93

ARTERIAL INSUFFICENCY

Front 94

what causes aching, cramping pain, PULSE PRESENT, skin discolored, toughened and rough

Back 94

VENOUS INSUFFICIENCY

Front 95

how do you check a pt for venous insufficencty

Back 95

have them stand

Front 96

a SPLIT S2 is heard best over where?

Back 96

Pulmonic

Front 97

listen to SPLIT S2 w/

Back 97

DIAPHRAGM - CHANGES w/ RESPIRATION

Front 98

where is a S3 heard best?

Back 98

4th - 5th ICS, Left sternal border or MCL ...listen with BELL

Front 99

where is S4 heard the best?

Back 99

S4 Is heard the best at APEX of heart

Front 100

Where is SPLIT S1 sound loudest?

Back 100

TRICUSPID

Front 101

SPLIT S4 is louder where?

Back 101

MITRAL

Front 102

What is heard at the Mitral Area with bell of steth?

Back 102

Point of Max Impulse

Front 103

what kind of murmor is NEVER ok

Back 103

Diastolic

Front 104

S3 and S4 can be at the SAME time (example is CHF AND HTN)

Back 104

TRUE

Front 105

ABNORMAL PULSES

double peak , cause is a HEART malfunction

Back 105

BISFERIENS

Front 106

changes in amplitutude of pulse (lv failure)

Back 106

Pulses Alternans

Front 107

irregular rhthm and one strong beat followed by a weak beat

Back 107

BIGEMINAL

Front 108

pulse that DECREASES on INSPIRATION (lung disease)

Back 108

Paradoxical

Front 109

In the elderly, what happens to BP?

Back 109

BP increases with age

Front 110

BP increasing with age in elderly is due to

Back 110

Arterisclerosis and Atherosclerosis

Front 111

The elderly pulse increases and takes longer to recover w/

Back 111

excercise

Front 112

baroreceptor response to positional changes in less efficient causing

Back 112

orthostatic hypotension

Front 113

the elderly have stronger ________ pulsees

Back 113

the elderly have stronger PROXIMAL pulses

Front 114

the elderly have weaker __________

Back 114

The elderly have weaker DISTAL PERIPHERAL PULSES

Front 115

what do the elderly have due to age related calfications

Back 115

Systolic Murmors (ok) and S4

Front 116

best area to hear AORTIC VALVE close

Back 116

aortic area

Front 117

best area to hear the PUILMONIC VALVE

Back 117

pulmonic area

Front 118

best spot to pick up MURMORS

Back 118

Erbs point

Front 119

best spot to pick up TRICUSPID VALVE

Back 119

TRICUSPID area

Front 120

best to hear MITRAL valve

Back 120

MITRAL area

Front 121

2nd ICS , LSB

Back 121

Pulmonic Area

Front 122

4th-5th ICS, LSB

Back 122

Tricuspid area

Front 123

2nd ICS - RSB

Back 123

Aortic area

Front 124

5th ICS, Left MCL

Back 124

Mitral area

Front 125

3rd ICS - LSB

Back 125

ERBS POINT

Front 126

Where do you hear S1 loudest?

Back 126

TRICUSPID AND MITRAL

Front 127

where do you hear S2 loudest?

Back 127

Pulmonic (aortic)